Glioblastoma Extent of Resection and Survival

cranial radiographic imagery

Students

Project Summary

This Summer I worked alongside Dr. Kalil Abdullah at the Department of Neurosurgery of the Hospital of the University of Pennsylvania. My project focused on Glioblastoma, which is an intrinsic brain tumor with among the shortest survival rates of all solid cancers and is invariably fatal. Surgical removal is the first step in treatment of this disease and new research uses advanced MRI techniques to predict recurrence patterns to better guide initial surgical resection.  However, as it stands the determination of tumor volumes (both before and after surgery) remains a cumbersome task that requires substantial manual input.

The purpose of this research was to develop a tool that could automate the process of calculating the extent of intrinsic tumor resection with an objective and consistent method, while minimizing a clinician’s time spent manually segmenting MRI images. After creating a computer extension, we applied it to an extent of resection association study to guide maximal surgical resection. While the extent of resection (EOR) in Glioblastoma multiforme (GBM) patients has been confirmed as the predominant prognostic factor, there is less certainty regarding a patient’s survival time in association with the EOR of tumors in varying anatomical locations. We established an association with extent of resection of enhancing and non-enhancing GBM regions in different anatomical locations with survival. My research showed that gross total resection improves overall survival, and maximal surgical removal (with additional borders for non-enhancing cells) should be attempted if safely possible.

This summer I have created a foundation for my research, and look forward to testing its applicability to other types of brain lesions in the future. My time working on this project over the summer was extremely informative as I learned about topics such as glioblastoma, neurosurgery, and radiology in-depth. I have gained a greater understanding about the process of scientific investigation, and appreciate the complexities of research. Going through many journals and articles on my topic of study has allowed me to analyze information more effectively since I was not only learning information, but also applying it to my experimental design. This research experience also made me realize what a career in academic medicine would truly be like, so it will make me consider different graduate school and career paths.